![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
Posted by 4mygrls on August 24, 2004, at 9:59:09
In reply to RE: getting more depressed on lamictal?, posted by karen m. on August 24, 2004, at 1:07:26
i went on lithobid. it didn't work out either. i can't take mood stabilizers. they all make me worse. i don't know why but i get more moody on them.
Kathi
Posted by prodgirl on August 24, 2004, at 11:32:36
In reply to RE: getting more depressed on lamictal?, posted by karen m. on August 24, 2004, at 1:04:54
> i hope someone like chemist will answer that for you. he is the best knowledge supply!
> i do know that i have read in other posts here that being part of a research group is a great way to go. they say you get the best cutting edge treatments that way. has your experience been such that that is true?I think that my involvement in a research study has helped me to have a second opinion from a great pdoc for free. It has helped me to learn more about myself and actions. Unforturnately, I do not have health insurance, so this is the closest I get to any type of therapy.
If there are research studies near you, they can be great for you, as long as your pdoc agrees. It can be a good place to try new cuting edge meds as well.
Posted by Starlight on August 24, 2004, at 13:15:52
In reply to RE:getting more depressed on lamictal?, posted by BJM on August 23, 2004, at 9:18:06
Lamictal is not an anti-depressant. It's just a mood stabilizer so while it may help you from going too deep into depression, it's not going to help lift you out of it. It has a bit of a mood lifting quality at first, but it wears off over time. I agree completely with adding an anti-depressant, only I advocate for Effexor or Wellbutrin if you're having weight issues as well. The only thing you have to watch for is aggravation or irritation with wellbutrin. But both of those drugs have been more associated with weight loss rather than gain. Pretty much all the others will make you gain, and I have never ever understood why a pdoc would prescribe an anti-depressant that causes weight gain - which to me would be even more depressing.
Good luck
Starlight
Posted by Starlight on August 24, 2004, at 13:19:48
In reply to RE:getting more depressed on lamictal?, posted by Starlight on August 24, 2004, at 13:15:52
Alot of people give effexor a bad rap, but I personally love it. It has helped me more than any other anti-depressant I have taken thusfar. I haven't of course, experienced the withdrawl from it, but every anti-depressant that I have withdrawn from has had negative effects during the withdrawl, so I'm not scared of that.
And sometimes, Lamictal alone is not enough of a mood stabilizer. I take both Lamictal and Trileptal.
starlight
Posted by BJM on August 24, 2004, at 16:47:16
In reply to RE:getting more depressed on lamictal?, posted by Starlight on August 24, 2004, at 13:15:52
I gained alot of weight from Effexor. So as usual it just depends on the person. I agree with the Wellbutrin causing agitation. When I took it I just kept feeling like I wanted to punch everybody in the nose. ESPECIALLY if I had even just 1 cup of coffee. My friends and family begged me to stop taking it. Its so tough finding the right meds. Each person reacts so differently and you don't know how you are going to do until you've invested alot of time and tears.
Posted by karen m. on August 24, 2004, at 17:19:46
In reply to RE:getting more depressed on lamictal?, posted by Starlight on August 24, 2004, at 13:19:48
do you like the trileptal with the lamictal?
Posted by karen m. on August 24, 2004, at 17:21:50
In reply to RE:getting more depressed on lamictal?, posted by BJM on August 24, 2004, at 16:47:16
i had the same reaction to wellbutrin. i was realllly cranky. went off it. i tried effexor previously but side effects caused me to go off it too. i wonder if lamictal can make some ssri's that were previously intolerable, now tolerable. too farfetched?
Posted by poop'd-out on August 25, 2004, at 0:38:17
In reply to RE: getting more depressed on lamictal?, posted by prodgirl on August 23, 2004, at 15:50:15
> I am taking 400 mg of Lamictal as well, and my pdoc just added 50 mg of Zoloft. It's been two weeks, and I just had a horrible weekend where I didn't want to leave my apartment, stayed in bed, really bad depressive episode.
>
> I feel better on Lamictal, however, I am also more emotional. I am part of a research project and my pdoc there has suggested that adding Topomax to the Lamictal might be a good thing (no AD).
>
> Started out on Lexapro, then evil Effexor before dx as BPI. Is going back to another AD good?
>
> Any ideas?I don't know whether you should add the topomax, but in terms of adding an AD, I would definitely go with the Prozac.
I was on the Prozac for a short while with the Lamictal and they really seemed to work well together. I personally cannot tolerate the Prozac though.
I really do hope you are feeling better soon.
Beth =)
Posted by BJM on August 25, 2004, at 8:12:41
In reply to RE: getting more depressed on lamictal? » prodgirl, posted by poop'd-out on August 25, 2004, at 0:38:17
> I don't know whether you should add the topomax, but in terms of adding an AD, I would definitely go with the Prozac.
>
> I was on the Prozac for a short while with the Lamictal and they really seemed to work well together. I personally cannot tolerate the Prozac though.
>
> I really do hope you are feeling better soon.
>
> Beth =)I second the vote for Prozac. Thats been the best one by far for me. And it can most definetly work well at a really low dose so you can minimize side effects. Zoloft had me just about suicidal within a matter of days (and at a very low dose). I've tried pretty much all of the AD's and Prozac has been the most managable. If the side effects get to be too much in the beginning you can just skip a day and the next time you take it your body will already be better adjusted.
Hope that helps a little.
BJM
Posted by Starlight on August 25, 2004, at 14:10:02
In reply to RE:getting more depressed on lamictal? ? Starlight, posted by karen m. on August 24, 2004, at 17:19:46
Yes. I take 300 Lamictal and 1800 Trileptal and have had no adverse effects, and I take 75 mgs of the Effexor.
starlight
Posted by Starlight on August 25, 2004, at 14:11:05
In reply to RE:getting more depressed on lamictal? ? BJM, posted by karen m. on August 24, 2004, at 17:21:50
It didn't for me. I tried the wellbutrin before the Effexor and it caused me agitation even on the mood stabilizers.
Starlight
Posted by Starlight on August 25, 2004, at 14:12:10
In reply to RE:getting more depressed on lamictal?, posted by Starlight on August 25, 2004, at 14:11:05
I've never tried Prozac but doesn't it cause more weight issues?
Posted by BJM on August 25, 2004, at 17:07:28
In reply to RE:getting more depressed on lamictal?, posted by Starlight on August 25, 2004, at 14:12:10
I almost always lose weight from Prozac. I've only gained weight from it when my dosage was raised to 40mg. I've taken it off and on (mostly on) for the past 10 years. At 10 or 20 mg I tend to lose weight. But of course, I've had friends on it that have gained but they all were taking something else with it so its hard to say if it was the Prozac. Sometimes I think the weight gain comes from the AD pooping out and the depression coming back. But increased appetite and weight gain has always been one of my depressive symptoms.
Posted by karen m. on August 25, 2004, at 19:12:58
In reply to RE:getting more depressed on lamictal?, posted by BJM on August 25, 2004, at 17:07:28
i had problems with prozac side effects emerging after a year and a half. But...that being said, i definately was higher than 20 mg. Maybe if i stayed at 20mg i wouldn't get the side effects. it sounds like from most of these posts that the lamictal is good at augmenting small doses of a/d's. it might be sufficient. thanks to all.
Posted by BJM on August 26, 2004, at 18:00:17
In reply to RE:getting more depressed on lamictal? » BJM, posted by karen m. on August 25, 2004, at 19:12:58
I've also had side effects that showed up from long term use but more so at the 20mg and above range. My OB was the first person to tell me that he has had plenty of patients that have done just as well at 5 and 10 mg. Since then my psych has said the same thing. She is actually pretty insistant on my not going higher than 10 now because she feels that I actually get worse. Thats where the lamictal came in. Before the Lamictal she had added Provigil for the fatigue and as a mood enhancer and it really helped alot. I wouldn't go without it.
Posted by CraigD on August 26, 2004, at 22:24:26
In reply to RE:getting more depressed on lamictal?, posted by BJM on August 23, 2004, at 9:18:06
> This is just my opinion but its based on my experience and doctors info. Lamictal without an AD is not necessarily so great. Its not strong enough as an AD. Better as a mood stabilizer, AD booster with a little AD properties. The weight gain could also be from the depression coming back. That always happens to me. It seems like a number of people who have started gaining weight with Lamictal have also stopped their AD's.
> If you are BPII weight gain can definetly be a symptom of depression. I've noticed that taking a smaller dose of Lamictal with a very small dose of Prozac has helped better than the Prozac alone.
> Best Wishes
I am very interested in your experiences. I am on my third bout with SSRIs. Each time I've come off them due to the tendency to act out on them and/or emotional blunting.My dad and sister are both bipolar I, but I've never had a full-blown mania -- mostly depressive and anxious.
So as a "shot in the dark" my pdoc had me add Lamictal to my Celexa (40 mgs). I am supposed to titrate up to 400 mgs per day, but at 50 mgs I am already feeling a little flaky and no emotions.
I was trying to explain to my mother how I felt over the past two days and I realized I really haven't felt anything at all!
My urge to drink and act out has definitely dipped, but one of my complaints about the Celexa has been missing out on the more complex and subtle feelings -- such as enjoying a night at home or starting to fall in love with someone.
So I am intrigued by the idea of lowering my Celexa and staying at a low dose of lamictal. The 400 mgs he prescribes seems high to me. Any suggestions? BTW my depression definitely has some psychotic edges to it (I think a previous poster mentioned that).
thanks
Posted by theo on August 27, 2004, at 7:15:02
In reply to RE:getting more depressed on lamictal? » BJM, posted by CraigD on August 26, 2004, at 22:24:26
I'm not taking any antidepressant yet, but started on Lamictal 12 weeks ago and got to max dose 150mg. When I started at 25mg and everytime I increased dose by 25mg, I would feel good for a few days and then the good feeling would wear off. It leveled out at 100mg and when I went to 125mg felt no initial good feeling and the same at 150mg.
Even though this is a small dose, my doc was mainly prescribing it to me for antidepressant effects.
I did stay at 150mg for about 15 days and felt like sitting on my couch and staring at the wall. Not depressed but lack of interest to do anything I normally enjoy doing, movies, workout, etc.
I saw my doc yesterday and she dropped me back down to 100mg and wants me to give it a few weeks to see how I do. If it's still bogging me down I'll scrap it and try something different.
I was really kind of bummed because I thought Lamictal might be the one, plus it takes so long to get to a theraputic dose.
Posted by Emme on August 27, 2004, at 8:22:14
In reply to RE:getting more depressed on lamictal? » CraigD, posted by theo on August 27, 2004, at 7:15:02
My pdoc has said it can take several weeks to get an AD response from Lamictal - or at least to get the maximum benefit that you're going to get. Don't give up on it too soon.
> I'm not taking any antidepressant yet, but started on Lamictal 12 weeks ago and got to max dose 150mg. When I started at 25mg and everytime I increased dose by 25mg, I would feel good for a few days and then the good feeling would wear off. It leveled out at 100mg and when I went to 125mg felt no initial good feeling and the same at 150mg.
>
> Even though this is a small dose, my doc was mainly prescribing it to me for antidepressant effects.
>
> I did stay at 150mg for about 15 days and felt like sitting on my couch and staring at the wall. Not depressed but lack of interest to do anything I normally enjoy doing, movies, workout, etc.
>
> I saw my doc yesterday and she dropped me back down to 100mg and wants me to give it a few weeks to see how I do. If it's still bogging me down I'll scrap it and try something different.
>
> I was really kind of bummed because I thought Lamictal might be the one, plus it takes so long to get to a theraputic dose.
Posted by BJM on August 27, 2004, at 8:27:03
In reply to RE:getting more depressed on lamictal? » BJM, posted by CraigD on August 26, 2004, at 22:24:26
Well it definetly depends on your diagnoses how each med will work for you. I can say that I had emotional blunting over time from Celexa also. Effexor had the same effect. I haven't really noticed it with Prozac. As a matter of fact my emotions coming back are the first sign to me that the Prozac is working. Sometimes a little to drastically in the beginning but it levels out.
My understanding is that for depression or bipolar the Lamictal shouldn't need to be much higher than 200mg. But everybody is different. Some people begin to feel relief as low as 50mg but the docs tend to keep upping it to the target of 200. My doc knows that more is never better in my case and always makes me worse so she will let me stop at whatever point I feel is right.
Just an aside about target dose too....There is alot of research evidence that people have done just as well on lower doses than the standard prescribing dose on a number of meds (Prozac being one of the biggies). Maybe they are trying to be on the safe side in making sure that people aren't undermedicated. Especially if they are in dire straits. Or maybe they are trying to cover their own butts or trying to make a buck. Ya never know.
I'm just curious...what has your actual diagnoses ended up to be?
Posted by CraigD on August 27, 2004, at 9:56:19
In reply to RE:getting more depressed on lamictal?, posted by BJM on August 27, 2004, at 8:27:03
> Well it definetly depends on your diagnoses how each med will work for you. I can say that I had emotional blunting over time from Celexa also. Effexor had the same effect. I haven't really noticed it with Prozac. As a matter of fact my emotions coming back are the first sign to me that the Prozac is working. Sometimes a little to drastically in the beginning but it levels out.
> My understanding is that for depression or bipolar the Lamictal shouldn't need to be much higher than 200mg. But everybody is different. Some people begin to feel relief as low as 50mg but the docs tend to keep upping it to the target of 200. My doc knows that more is never better in my case and always makes me worse so she will let me stop at whatever point I feel is right.
> Just an aside about target dose too....There is alot of research evidence that people have done just as well on lower doses than the standard prescribing dose on a number of meds (Prozac being one of the biggies). Maybe they are trying to be on the safe side in making sure that people aren't undermedicated. Especially if they are in dire straits. Or maybe they are trying to cover their own butts or trying to make a buck. Ya never know.
> I'm just curious...what has your actual diagnoses ended up to be?
It's up in the air. Mixed depression and anxiety (especially social). There are still questions about possible BPII (Dad and sister are BPI), PTSD (sexual abuse as a kid) and ADD (trouble concentrating)However, my pdoc refuses to put me on any benzos or stims because of a past history of absue. He doesn't listen to me when I tell him the abuse only occured when he put me on SSRI's, as did the excessive spending and sexuality (despite a reduced drive).
He told me my depression wasn't typical, especially when I told him that NE drugs made me very sad and occasionally angry. He's kind of flaky himself.
Posted by theo on August 27, 2004, at 10:00:43
In reply to RE:getting more depressed on lamictal? » theo, posted by Emme on August 27, 2004, at 8:22:14
I'm not giving up but my doc said once you get to a point, and start to feel slowed, thats when you probably need to back down. She said once you get past 150mg, you start to get more of a stabilzing effect which I don't need, just the antidepressant effect. So I'm backing down to 100mg for a few weeks versus increasing the dose.
One can end up chasing the antidepressant benefits and be a non-funtioning individual because they are over stablized.
That's just her opinion.
Posted by CraigD on August 27, 2004, at 10:30:52
In reply to RE:getting more depressed on lamictal? » Emme, posted by theo on August 27, 2004, at 10:00:43
> I'm not giving up but my doc said once you get to a point, and start to feel slowed, thats when you probably need to back down. She said once you get past 150mg, you start to get more of a stabilzing effect which I don't need, just the antidepressant effect. So I'm backing down to 100mg for a few weeks versus increasing the dose.
>
> One can end up chasing the antidepressant benefits and be a non-funtioning individual because they are over stablized.
>
> That's just her opinion.
In your opinion, does lamictal have stabilizing effects at lower doses? I'm feeling pretty flat at 50 mgs...of course I'm also on 40 mgs of Celexa.cheers
Posted by Starlight on August 27, 2004, at 11:30:10
In reply to RE:getting more depressed on lamictal? ? CraigD, posted by theo on August 27, 2004, at 7:15:02
I would say that the Lamictal has limited anti depressant effects that appear in the beginning, and then it's mainly a mood stabilizer that may not be enough to stave off depression. I take 300 mgs and think it's a good drug for mood stabilization, but that an anti-depressant will likely need to be added eventually. I too found that the initial high wore off after a while, but it's still a very effective drug for what it does. The trick is to understand that it's not fully effective for lifting a long term depression. You might look for some research regarding this and take it with you to your next appointment since I don't think a lot of doctors have a good understanding of it.
At least mine didn't. He was determined to get me on lithium or depakote. I went and did all the research and then came back with a stack of articles, to which he responded that it wasn't FDA approved. I said "Don't even get me started on the FDA!" and he finally gave in and thank god! Much, much, much better drug than either one of those! No side effects, no having to test the liver or get blood levels.
starlight
Posted by theo on August 27, 2004, at 13:25:59
In reply to RE:getting more depressed on lamictal? » theo, posted by CraigD on August 27, 2004, at 10:30:52
Kind of at 100mg, but at 150mg I started feeling to flat with no improvement in antidepressant effects which is what the doc prescribed it to me for. This med is a tuff one to pinpoint
Posted by BJM on August 27, 2004, at 21:39:15
In reply to RE:getting more depressed on lamictal? » BJM, posted by CraigD on August 27, 2004, at 9:56:19
> It's up in the air. Mixed depression and anxiety (especially social). There are still questions about possible BPII (Dad and sister are BPI), PTSD (sexual abuse as a kid) and ADD (trouble concentrating)
>
> However, my pdoc refuses to put me on any benzos or stims because of a past history of absue. He doesn't listen to me when I tell him the abuse only occured when he put me on SSRI's, as did the excessive spending and sexuality (despite a reduced drive).
>
> He told me my depression wasn't typical, especially when I told him that NE drugs made me very sad and occasionally angry. He's kind of flaky himself.
>
>
>
Wow you sound alot like me. Still up in the air about the BPII also. There are antianxiety meds that aren't as addicting now (ex. Klonopin) and Provigil for a stim if you can call it that that doesn't seem to have the same potential for abuse. Works great for me. Keeps me awake during the day without the speedy feeling. SSRI's by themselves sometimes send me into spending sprees or craving alcohol. Celexa got me on that one.
We'll see how the Lamictal goes. It seems o.k. for now but I'm really hesitant to put too much faith in anything new. If there is a potential for any side effect I usually get it.
Lots of Luck!!!!
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.